After Treatment Instructions

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1 After Treatment Instructions On this page you will find instructions on how to care for your mouth after you have received specific dental treatments. These are general guidelines, and if you have questions that aren't answered here, please call our office. Also, if you experience any severe discomfort, or any symptom that seems abnormal, please call our Periodontal Treatment: You are in the process of having a procedure called deep scaling and root planning, or simply root detoxification. Its purpose is to remove all deposits of calculus (tartar) and plaque on the teeth below the gum line and to methodically plane, or smooth, the root surfaces themselves, thus removing the disease-causing toxins. This procedure helps the gums to reattach to the tooth roots. This will reduce bleeding and inflammation and cause the spaces around the teeth to become less deep. After scaling and root planning is completed you may experience slight discomfort around the teeth for a couple of days and perhaps increased sensitivity to hot and cold (and sometimes sweets) for up to four to six weeks. This is the normal course of healing. You should begin to notice an improvement in sensitivity within two weeks. There are several things you can do to help reduce or prevent tooth sensitivity and hasten healing. These include: 1. Thorough plaque removal on a daily basis with toothbrush and floss. 2. Use of desensitizing toothpaste in place of your regular brand. 3. A topical stannous fluoride gel may be prescribed to use twice daily. 4. A prescription antibiotic may be recommended during your treatment The benefits of root planning and scaling are many. Depending on the severity of your disease, this procedure alone may not be sufficient to stop the continued destruction of periodontal disease. Approximately one to three months after we complete the scaling and root planning, we will re-evaluate your periodontal status. It is at this appointment that we will determine if further treatment is necessary to control the disease process. Whitening Your teeth will maintain their brightness for several weeks. Your personal habits can have an effect on the color of your teeth. To keep your teeth as bright as possible, as long as possible, we recommend:

2 Hygiene: Brush and floss your teeth twice daily. Use toothpaste accepted by the American Dental Association, to get optimal benefit from fluoride and to ensure it is not abrasive. Diet: Avoid foods which can stain the teeth, such as coffee and tea. Habits: Tobacco products may accelerate the loss of brightness. Sensitivity: Occasionally patients report their teeth are sensitive to air or temperature changes after whitening. This usually resolves within a few days after you stop using the product. Be sure to use fluoridated toothpaste. Touch-up Instructions: To maintain your level of brightness, you will need to "touch-up" your teeth occasionally. Most people find they have to do this every three to six months. To "touch up" you insert the whitening gel into your trays and wear the trays to bed one or two nights (or for a minimum of four hours). If you need more gel, it is available to purchase in a touch-up kit. Just call our office or ask one of us at your next visit. Restorations (Fillings) What You May Experience If you had local anesthesia ("Novocain") there is a tendency to bite one's tongue or cheek and a conscious effort must be made to avoid this. We ask that you especially observe your child for this possibility. Some soreness and stiffness may be experienced for a day or two after the anesthetic has disappeared. This is normal and should be of no concern to you. New restorations are often sensitive to hot and cold as the filling material will conduct temperature changes to the pulp (nerve) of the tooth. We paint an insulating base under all fillings to help alleviate some of this sensitivity. If the restoration was deep, a sedative cement was also placed under the restoration to aid in insulation and protection. Depending on the size of the filling, and other factors, this sensitivity can last from a few weeks to a few months, or even longer. If the filling feels high after the anesthetic has worn off, please call the office and make an appointment for the filling to be adjusted. A high filling can result in increased sensitivity, possible fracture of the filling or tooth, and a change in bite. It is virtually impossible to tell if a filling needs adjustment until the anesthetic has worn off, so please pay attention to this tomorrow. Composite (Tooth-Colored) Restorations The composite filling has reached its final hardness before you leave the office. You may feel

3 free to eat anything after the anesthetic has worn off. You may brush normally and start flossing the new filling today. Amalgam (Silver) Restorations The silver filling placed in your tooth will not reach its final hardness for a period of approximately 24 hours. We suggest, therefore, the following types of food to be eaten during this period: a soup with no substance, mashed potatoes, cottage cheese, plain Jell-O, pudding, milk shake, fruit juices, macaroni, etc. Any foods which may contain hard pieces of particulate matter (such as pepper, bone or pits) should be avoided. Do NOT floss near the new filling until tomorrow. You may brush normally. Crown Preparation You are wearing a temporary crown to protect your tooth between the crown preparation and crown insertion appointments. This crown is held in place with temporary cement which will allow the crown to be easily removed without trauma to your tooth at the next appointment. For that reason, chewing on the crown should be avoided, especially chewy, sticky foods which might dislodge the crown, or crunchy foods which may fracture it, or your tooth. Should your temporary crown come loose, call us. You may replace it yourself, with or without adhesive. If you d like to use adhesive, there are over the counter adhesives (with directions for use) available at the 24 hour pharmacy on Cedar Ave in Apple Valley. Your gum tissue will be tender after the anesthetic has worn off. The cleaner you keep the tissue, the sooner it will heal. If it is too tender to brush with a toothbrush you may clean the area with a Q-tip moistened in warm water. Floss your temporary crown each day. After cleaning under the gum tissue, remove the floss by sliding it out toward your tongue or cheek. Do not snap the floss out toward the biting surface as the crown may be loosened. If the crown should come loose, call our office for an appointment to have it recemented. Sensitivity to hot and cold is to be expected and should be of no concern, unless it lingers after eating. The temporary has been kept short of the gum tissue where possible to aid in healing. However, that exposes tooth structure which may be sensitive to touch, temperature and air. Crown Insertion Do not chew on your new crown, or floss around it, until tomorrow. It will take that long for the cement to reach its final hardness. The cement acts as a seal and we don't want the seal to form with "cracks" in it. A tooth with a new crown is often sensitive to temperature changes. If the initial insult to the tooth (decay, fracture, etc.) was not too severe, this sensitivity should improve during the next

4 few months. Call our office for an appointment to evaluate the nerve of the tooth if the sensitivity increases in intensity or duration over the next several months. Bonding and Veneers Your veneers have been permanently bonded to your teeth. When cared for properly they can maintain their beauty for years. Hygiene: Brush and floss your veneers as you do your natural teeth. Be sure to wrap the floss under the gum line and around the front and back of the tooth to remove the plaque below the gum line. Use toothpaste accepted by the American Dental Association, to ensure that's it's not too abrasive. Please keep all of your scheduled appointments with your hygienist. Diet: Avoid foods that may stain the natural tooth structure adjacent to the veneers, such as coffee and tea. Forces that could damage your natural teeth could damage veneers, also. Use care not to bump them with ice cubes, and do not chew ice. Exercise caution when eating foods that may contain hidden hard objects (such as ground meat, popcorn, foods with nuts, etc.). If your veneers are on your front teeth, use care when you bite into foods when that action brings the edges of the top and bottom teeth together. The veneer is most fragile at the biting edge. For example, as you bite into an apple, use gentle force as you bite the apple. Then when you remove the remainder of the apple, use gentle pressure with your hand, and avoid "pulling" or "tearing" motions. Habits: Avoid biting on the edges of the veneers with pens, fingernails, bobby pins, etc. Do not use these teeth to open plastic bags, to cut fishing line, or to remove the tags off new clothes. If you have any questions or concerns, please call us at Sealants The plastic sealant material placed on your teeth (or those of your child) has reached its final hardness. You may now eat, drink, floss and brush normally. The sealant acts to decrease the likelihood of decay occurring on the chewing surface of the tooth. The chewing surface is the surface which is most susceptible to decay. The sealant does

5 NOT protect the flossing surfaces nor does it protect the surfaces next to the cheek and tongue. The sealant is not a guarantee against decay, but it is the best protection available. You must continue to thoroughly brush and floss the entire tooth to prevent decay. The sealant is tinted white so that you can see it easily. Some wear of the plastic will occur as the material is abraded by food particles, tooth brushing, etc. The material deep in the pits and grooves will be protected from wear by the adjacent tooth structure and will continue to function for five to seven years. It will appear as thin thread-like lines on the chewing surface. Occasionally a sealant will come off. If this occurs, it is usually within the first month after placement. Therefore, we ask that you look at the sealants frequently in the next few weeks. If one should be absent please call our office to arrange an appointment for replacement (we will replace sealants at no charge for a period of one year). It can be reapplied as often as necessary, though a single application may be all that is needed. We will check the sealants at each of your reexamination appointments to be certain they are present and functioning correctly. Extractions Following extractions some bleeding is to be expected. If persistent bleeding occurs, place gauze over extraction area and bite firmly for 30 minutes. Repeat if necessary. For mild pain use Advil, Motrin or any aspirin type pain reliever you like. For children use Tylenol only. Keep your diet light during the first 24 hours, avoid smoking or using a straw. Do not rinse your mouth today. Tomorrow, rinse gently every 3 to 4 hours using 1//4 teaspoon salt to a glass of very warm water. This may be continued for several days. To avoid swelling, an ice bag may be applied to the area for 30 minutes in on/off intervals the first 4 to 5 hours.

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